820 research outputs found

    Colposcopy in the Primary Health Care: A Scoping Review

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    Aim: Low- and middle-income countries represent nearly 85% of all cervical cancer cases worldwide; thereby, it is extremely important to identify methods to improve the screening process. Therefore, this study aimed to summarize the primary characteristics of studies on accessibility, coverage, patient preferences, and factors associated with patient satisfaction or acceptance of colposcopy in primary healthcare. Methods: A search strategy, based on MeSH, Emtree, and free terms, was run through 5 databases (PubMed, Scopus, Embase, Ovid/Medline, and Web of Science). EndNote 20.1 © and Rayyan QCRI © were used for screening. A preset datasheet was used for data extraction. Results: The systematic search retrieved 1127 references, and after removing duplicates, screening the titles and abstracts, and reviewing the full text, 7 studies were included. The interrater reliability was 77.73% (kappa statistic = 0.1842). Most studies estimated the proportion of women that sought for colposcopy after a previous screening test for human papilloma virus. One study identifies barriers to colposcopy examination in women at risk of developing cervical cancer. Three studies assessed the decentralization of colposcopy from a tertiary healthcare center to a primary care center. Pap smear was the most common first-line screening test, followed by liquid-based cytology sample and visual inspection with acetic acid. Conclusion: Only a few countries have investigated the use of colposcopy in primary care. Thus, barriers and the care structure for this implementation to be successful in reducing cervical cancer incidence and mortality should be identified.Revisión por pare

    Escherichia coli O157:H7 Productor de toxina Shiga aisladas de muestras de agua relacionadas a Establecimientos pecuarios de engorde a corral

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    Recientemente han ocurrido brotes debido vegetales contaminados por Escherichia coli productor de toxina Shiga (stec). Estos productos frescos se contaminan a través del contacto directo de heces bovinas (abono), o indirectamente a través de irrigación con agua contaminada. Este estudio tuvo como objetivo establecer la prevalencia de stec O157:H7 en muestras de agua relacionadas a establecimientos pecuarios de engorde a corral (epec) de la provincia de Entre Ríos, Argentina, y su eventual relación con cepas vinculadas a enfermedad transmitida por alimentos. Usando como indicadores microbiológicos, coliformes, Escherichia coli, y anaerobios sufito-reductores, se estudió la eficiencia en el saneamiento de los efluentes de un epec que contaba con un sistema de lagunas sanitarias. Entre abril/2009 y julio/2011 se estudiaron 320 muestras de agua vinculadas a efluentes de 11 epec. Las cepas fueron caracterizadas feno-genotípicamente y subtipificadas por macrorrestricción y electroforesis de campo pulsado. Algunos de los perfiles identificados están incluidos en la base de datos nacional, correspondiendo a cepas obtenidas de casos de Síndrome Urémico Hemolítico, diarrea, muestras alimenticias y de origen animal. Los epec deben implementar estrategias de control con objeto de limitar el ingreso de stec en el medioambiente acuático. En el sistema de lagunas sanitarias estudiado se constató una franca disminución de los indicares utilizados pero insuficiente para eliminar su aporte al ambiente. La optimización de su funcionamiento es función de su mantenimiento, en especial la frecuente remoción de barros de las primeras piletas

    IgA Anti-β2-Glycoprotein I Autoantibodies Are Associated with an Increased Risk of Thromboembolic Events in Patients with Systemic Lupus Erythematosus

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    The clinical utility of testing for antiphospholipid antibodies (aPL) of IgA isotype remains controversial.To address this issue, we reasoned that if IgA aPL contribute to the clinical manifestations of the antiphospholipid syndrome, then an association with thromboembolic events should manifest in patients whose only aPL is of IgA isotype. We performed a retrospective chart review of 56 patients (31 with systemic lupus erythematosus [SLE] and 25 without SLE) whose only positive aPL was IgA anti-beta2-glycoprotein I (isolated IgA anti-beta2GPI) and compared their clinical features with 56 individually matched control patients without any aPL. Patients with isolated IgA anti-beta2GPI had a significantly increased number of thromboembolic events, as compared to controls. When patients were stratified into those with and without SLE, the association between isolated IgA anti-beta2GPI and thromboembolic events persisted for patients with SLE, but was lost for those without SLE. Titers of IgA anti-beta2GPI were significantly higher in SLE patients who suffered a thromboembolic event. Among patients with isolated IgA anti-beta2GPI, there was an increased prevalence of diseases or morbidities involving organs of mucosal immunity (i.e., gastrointestinal system, pulmonary system, and skin).The presence of isolated IgA anti-beta2GPI is associated with an increased risk of thromboembolic events, especially among patients with SLE. IgA anti-beta2GPI is associated with an increased prevalence of morbidities involving organs of mucosal immunity
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